Heuristic Value of LSD Research

Stanislav Grof, M.D.

Before we discuss the theoretical implications of LSD research,
it is necessary to justify the heuristic value of LSD as a tool
for the exploration of the human unconscious and the legitimacy
of drawing more general conclusions from the work with this compound.
There has been a tendency among many professions to discard the
experiences in LSD sessions as manifestations of a toxic alteration
of the brain function (toxic psychosis) that have little, if any,
relevance for the understanding of the human mind as it functions
under more natural circumstances. This is a rather basic and serious
objection that deserves special attention and careful consideration.
The pivotal question that has to be dealt with in this context
is whether there exist invariant, constant, and standard effects
of LSD that are purely pharmacological in nature, are unrelated
to the personality structure of the subject, and occur without
exception in every subject who takes a sufficient dose of this
drug.
The phenomena that can occur in the course of LSD sessions cover
an enormous range; there exist hardly any perceptual, emotional,
or psychosomatic manifestations that have not been observed and
described as part of the LSD experience. The extreme multiformity
and interindividual variability of the LSD state is complemented
by its equally striking intraindividual variability. If the same
person takes LSD repeatedly, each of his consecutive sessions
is usually very different from the others in its content, general
character, and course. This variability certainly is in itself
a serious objection to the idea that the LSD reaction has simple
chemical and physiological determinants. The proportion to which
various extrapharmacological factors participate in the LSD experience
is both interesting and theoretically important.
The search for the typical, mandatory pharmacological effects
of LSD was an important aspect of my analytical work on the LSD
data. The result of this quest was rather surprising; after analyzing
over thirty-eight hundred records from LSD sessions, I have not
found a single symptom that would be an absolutely constant component
in all of them and could thus be considered truly invariant. Changes
of optical perception are usually presented as a typical manifestation
of the LSD state and thus were a serious candidate for pharmacological
invariants. Although they occurred rather frequently in our records,
there were a number of high-dose sessions where alterations in
the optical realm were not present at all even though, in some
of these sessions, the dosage amounted to 500 micrograms. Several
of the LSD reactions without any visual phenomena had the form
of intense sexual experiences; others were characterized by massive
somatization manifested in various parts of the body, by feelings
of general malaise and physical illness, or by experiences of
excruciating pain. Special examples of sessions without optical
perceptual changes were observed in advanced stages of psycholytic
treatment and in some psychedelic sessions. These involved either
a brutal and primitive biological experiential complex described
by various subjects as reliving of their own birth or transcendental
experiences with a paradoxical quality of being "contentless
yet all-containing."
Physical manifestations of the LSD state deserve special notice
in this context, since, in the early reports, they were considered
simple pharmacological effects and a result of direct chemical
activation of the vegetative centers in the brain. Careful observations
of a large number of sessions and analysis of the records did
not support this explanation. The spectrum of the so-called "vegetative
symptoms" is very broad and exceeds that of any known drug
with the exception of some other psychedelics. Strangely enough,
these symptoms include both sympathetic and parasympathetic phenomena,
and they appear in clusters involving various combinations thereof.
The physical concomitants of the LSD reaction vary considerably
from session to session. They are practically independent of the
dosage used, and there is no demonstrable dose-effect relationship.
In many high-dose LSD sessions, physical manifestations were entirely
absent, or they occurred intermittently and in close association
with difficult and strongly defended unconscious material. Another
aspect of these symptoms that could be mentioned here is their
unusual sensitivity to various psychological factors; they can
often be modified or even terminated by various external influences
and specific psychotherapeutic interventions. One of the physical
manifestations of the LSD reaction deserves special emphasisnamely,
dilation of the pupils (mydriasis). It is so common that its presence
has been used by many experimenters and therapists as a reliable
indicator that the person is still under the influence of the
drug. For a long time, mydriasis was also a serious candidate
for an invariant manifestation of the LSD effect in my investigations.
Later, I witnessed several LSD sessions, some of them very dramatic,
in which the pupils of the subject appeared constricted, or in
which they oscillated rapidly between extreme dilation and constriction.
A situation similar to that of the vegetative symptoms existed
in the area of gross physical manifestations, such as muscular
tonus, tremors, twitches, seizure-like activities, and various
twisting movements. None of these symptoms was standard and predictable
enough to be considered a specific pharmacological effect of LSD.
This does not mean that LSD per se does not have any specific
physiological effects; these can be clearly demonstrated in animal
experiments, which use incomparably higher dosages. My experience,
however, indicates that, within the range of doses commonly used
in human experiments or in psychotherapeutic practice, physical
manifestations are not the result of a direct pharmacological
stimulation of the central nervous system. They seem to reflect
chemical activation of psychodynamic matrices in the unconscious
and have a structure similar to those of hysterical conversions,
organ-neurotic phenomena, or symptoms of psychosomatic disorders.
As unpredictable as the content of the LSD reaction is its intensity;
the individual responses to the same dosage level vary considerably.
My experience indicates that the degree of sensitivity or resistance
to LSD depends on complicated psychological factors rather than
on variables of a constitutional, biological, or metabolic nature.
Subjects who in everyday life have the need to maintain full self-control
and have difficulties in relaxing and "letting go" can
sometimes resist relatively high dosages of LSD (300 to 500 micrograms)
and show no detectable changes. Occasionally, a person can resist
a considerable dose of LSD if he has set this as a personal task
for himself for any reason. He may decide to do this to defy the
therapist and compete with him, to demonstrate his "strength"
to himself and to others, to endure more than his fellow patients,
or for many other reasons. Usually, however, more relevant unconscious
motives can be found underlying such superficial rationalizations.
Another cause for a high resistance to the effect of the drug
may be insufficient preparation, instruction, and reassurance
of the subject, a lack of his full agreement and cooperation,
or absence of basic trust in the therapeutic relationship. In
this case, the LSD reaction sometimes does not take its full course
until the motives of resistance are analyzed and understood. Occasional
sudden sobering, which can occur at any period of the session
and on any dosage level, can be understood as a sudden mobilization
of defenses against the emergence of unpleasant traumatic material.
Among psychiatric patients, severe obsessive-compulsive neurotics
are particularly resistant to the effect of LSD. It has been a
common observation in my research that such patients can resist
dosages of more than 500 micrograms of LSD and show only slight
signs of physical or psychological distress. In extreme cases,
it can take several dozen high-dose LSD sessions before the psychological
resistances of these individuals are reduced to the point that
they start having episodes of regression to childhood and become
aware of the unconscious material that has to be worked through.
The excessive resistance of obsessive-compulsive patients can
be illustrated by the following clinical example.

Erwin, a twenty-two-year-old student, was referred to the LSD
treatment program after four years of unsuccessful therapy for
a severe obsessive-compulsive neurosis. Over the years, he had
developed a very complicated system of obsessive thoughts and
became so preoccupied with it that it paralyzed all his other
activities. He was compelled to imagine in his mind's eye a geometrical
structure with two coordinate axes and locate within this system
all the problems and duties he encountered in his everyday life.
At times he spent many hours desperately trying to find the proper
location for some aspect of his existence, but always without
success. Before admission, he felt that the center of gravity
of his imaginary coordinate system was shifting to the left; this
upset him enormously and resulted in feelings of tension, apprehension,
anxiety, insecurity, and depression. In addition, Erwin suffered
from various psychosomatic symptoms and tended to interpret them
in a hypochondriacal way. He was referred for psycholytic therapy
after several hospitalizations and unsuccessful treatment with
tranquilizers, antidepressants, and drug-free psychotherapy. Erwin
manifested a rather spectacular resistance to the effect of LSD.
After psychological preparation of two weeks' duration, he started
having regular LSD sessions in weekly intervals. The initial dose
of 100 micrograms was increased by fifty to one hundred micrograms
every week, since he barely showed any response. Finally, he was
given 1500 micrograms intramuscularly, with the hope that this
would overcome his resistance. Between the second and third hour
of the session, when the effect of [SD usually culminates, Erwin
felt bored and a little hungry; according to his description as
well as external manifestations, nothing unusual was happening.
He seemed to be so well composed and in such full control that
he was allowed to go with the therapist to a kitchenette on the
ward, cut a piece of bread with a knife, open a can of liver paste,
and have a snack. After he was finished, he wanted to go to the
social room in the ward and play chess, because he felt he needed
some distraction from the uneventful and monotonous therapeutic
experiment.
It took thirty-eight high-dose sessions before Erwin's defense
system was reduced to the point that he started regressing into
childhood and reliving traumatic experiences.

It became obvious after this and similar observations that high
psychological resistance to LSD cannot be broken merely by an
increase in dosage and that it has to be gradually alleviated
by a series of sessions. It seems that there exists a saturation
point for LSD somewhere between 400 and 500 micrograms; if the
subject does not respond adequately to this dosage, additional
LSD will not change anything in the situation.
After demonstrating that LSD does not have any clear, invariant
drug effects on the dosage level commonly used in experimental
and clinical work with human subjects, we can ask what the effects
of LSD actually are. According to my experience, they are rather
unspecific and can be described only in very general terms. In
a great majority of sessions, there is an over-all tendency toward
perceptual changes in various sensory modalities. Consciousness
is usually qualitatively altered and has a dreamlike quality.
Emotional reactivity is almost always greatly enhanced, and affective
factors play an important role as determinants of the LSD reaction.
A rather striking aspect of the LSD effect is a marked intensification
of all mental processes and neural processes in general; this
involves phenomena of a different nature and origin. Pre-existing
and recent psychogenic symptoms as well as those that the individual
had suffered from in childhood or at some later period of his
life can be exteriorized, amplified, and experienced in the LSD
sessions. Traumatic or positive experiences from the past connected
with a strong emotional charge are activated, brought forth from
the unconscious, and relived in a complex way. Various dynamic
matrices from different levels of the individual and collective
unconscious can be brought to the surface and consciously experienced.
Occasionally, phenomena of a neurological nature can be amplified
and manifested in the sessions; frequently these are pains associated
with arthritis, dislocation of vertebral disks, inflammatory processes,
or postoperative and post-traumatic changes. Particularly common
is reliving of sensations related to past injuries and operations;
it is interesting from the theoretical point of view that LSD
subjects seem to be able to relive even pains and other sensations
related to past operations that were conducted under deep general
anaesthesia. The propensity of LSD to amplify various neurological
processes is so striking that it has been used with success by
several Czech neurologists as a diagnostic tool for the exteriorization
of latent paralyses and other subtle organic damage of the central
nervous system. The negative aspect of this interesting property
of LSD is the fact that it can activate seizures in patients suffering
from manifest epilepsy or those who have a latent disposition
to this disease.
By and large, I have not been able to discover during the analyses
of my data any distinct pharmacological effects of LSD in humans
that would be constant and invariant and could therefore be considered
drug specific. At the present time, I consider LSD to be a powerful
unspecific amplifier or catalyst of biochemical and physiological
processes in the brain. It seems to create a situation of undifferentiated
activation that facilitates the emergence of unconscious material
from different levels of the personality. The richness as well
as the unusual inter-and intraindividual variability of the LSD
experience can thus be explained by the decisive participation
of extrapharmacological factors, such as the personality of the
subject and the structure of his unconscious, the personality
of the therapist or sitter, and the set and the setting in all
their complexity. The capacity of LSD and some other psychedelic
drugs to exteriorize otherwise invisible phenomena and processes
and make them the subject of scientific investigation gives these
substances a unique potential as diagnostic instruments and as
research tools for the exploration of the human mind. It does
not seem inappropriate and exaggerated to compare their potential
significance for psychiatry and psychology to that of the microscope
for medicine or the telescope for astronomy.
In the following chapters, I have attempted to outline the cartography
of the human unconscious as it has been manifested in LSD sessions
of my patients and subjects. I have been quite encouraged by the
fact that in various areas of human culture there are numerous
indications that the maps of consciousness emerging from my LSD
work are fully compatible and sometimes parallel with other existing
systems. Examples of this can be found in C. G. Jung's analytical
psychology, Roberto Assagioli's psychosynthesis, and Abraham Maslow's
studies of peak experiences, as well as religious and mystical
schools of various cultures and ages. Many of these frameworks
are based not on the use of psychedelic drugs but on various powerful
nondrug techniques of altering consciousness. This parallel between
the LSD experiences and a variety of phenomena manifested without
chemical facilitation provides additional supportive evidence
for the unspecific and catalyzing effect of LSD.
The description of the new model of the unconscious based on LSD
research presents considerable difficulties. This model reflects
a multidimensional and multilevel continuum of mutually overlapping
and interacting phenomena. For didactic purposes, the object of
discussion has to be dissected and its elements isolated from
their broader contexts. Each attempt to communicate this model
in a linear form necessarily results in a certain degree of oversimplification
and artificiality. With full awareness of the disadvantages and
limitations involved in such an undertaking, we can delineate
for the purpose of our discussion the following four major levels,
or types, of LSD experiences and the corresponding areas of the
human unconscious: (1) abstract and aesthetic experiences, (2)
psychodynamic experiences, (3) perinatal experiences, and (4)
transpersonal experiences.

Epilog to Realms of the Human Unconscious

I am presenting this book to my professional colleagues and to
the general public with somewhat mixed feelings and not without
hesitation. I am fully aware how unusual and surprising some of
its sections must seem to a reader who has not had a firsthand
experience with psychedelics or some other type of altered state
of consciousness. I know from my own personal development how
difficult it was for me to consider seriously and accept the implications
of some of the quite extraordinary observations from LSD sessions.
I had resisted the influx of the revolutionary new data that I
was exposed to in my everyday clinical work and kept trying to
explain them within the accepted theoretical frameworks, until
my tendency to defend traditional ways of thinking was defeated
and overwhelmed by an avalanche of indisputable clinical facts.
Whenever I violated the boundaries of tradition, conventional
thinking, and commonly shared assumptions, it was only because
rather convincing evidence made the old concepts incomplete, unsatisfactory,
implausible, or untenable. I would like to emphasize in this context
that I did not indulge in iconoclastic pleasure in opposing the
existing concepts and theories. On the contrary, having been rather
conservative by nature, I experienced a considerable amount of
discomfort when the accepted systems proved inadequate. I had
to suffer through a long period of rather unpleasant conceptual
chaos, with a painful lack of any meaningful guidelines. This
lasted until I developed a broader theoretical framework that
seemed to introduce new order into the research data and made
possible a simplifying integration and synthesis of the most important
observations.
Looking for an appropriate form to communicate my findings, I
rejected what seemed to be a tempting alternative, namely censoring
or truncating some of the most unusual observations in order to
avoid disapproval and harsh criticism. In addition to being personally
and professionally dishonest, such an approach would have defeated
the very purpose for which this book was written. It seemed important
to share the data in their true form, including the challenge
that they represent to our common sense and to scientific thinking.
I have therefore decided to take the risk of attacks, fierce criticism,
and possible ridicule for the sake of integrity and accurate reporting.
I do not anticipate that it will be easy for the reader to accept
the ideas expressed in this book; it is reasonable to expect that
the skepticism of others in regard to the data will not be less
acute than that which I experienced myself. The most conclusive
confirmation or rejection of the presented material will have
to come from similar studies conducted by other researchers. Theoretically,
of course, the research described in this book is replicable,
even if the present political and administrative situation in
regard to drug investigations makes such a task rather difficult.
Indirectly, the validity of the presented concepts can be tested
in the situation of the uncontrolled experiment happening on a
large scale in the contemporary United States, namely the unsupervised
use of psychedelic drugs. The persons who have taken LSD and those
mental-health professionals who have worked with such individuals
will be able to judge to what extent the described cartography
of the unconscious is congruent with their experience. Another
indirect way of testing the new conceptual framework is to apply
it to various states in which the activation of the unconscious
material is induced by powerful nondrug techniques. Numerous examples
can be found in religious scriptures, mystical writings, and anthropological
books and journals, as well as in contemporary literature on experiential
psychotherapeutic techniques and laboratory mind-altering procedures.
The significance of the LSD observations transcends the framework
of psychiatry and psychology and extends to many other scientific
disciplines. It is far beyond the capacity of a single individual
to outline and evaluate all the implications and consequences
of the findings in their entirety. Detailed study of psychedelic
phenomena would require a long-term systematic team cooperation
of experts from diverse disciplines, such as psychology, psychiatry,
neurophysiology, neuropharmacology, ethnobotany, modern physics,
zoology, ethology, genetics, internal medicine, obstetrics and
gynecology, anthropology, history of art, theology, philosophy,
and comparative study of religion and mythology.
At the present time, the future of psychedelic research is problematic,
and it is uncertain whether it will be possible to replicate the
study of serial LSD sessions described in this book. In any case,
it will undoubtedly take a long time before such studies will
be completed and will generate new data. In the meantime, I would
like to offer the material on which this book is based for detailed
analysis to every serious researcher who finds it of interest
from the point of view of his own discipline. In turn, I would
appreciate any critical comments and suggestions from the specialists
of various disciplines that would help to clarify the findings
described in this volume.